Compliance

Modern medical science has given us longer, better lives.  Hospitals are full of magical contraptions--Xrays and CT scans and lasers and radioactive sugar and giant magnets.    Capsules, tablets and IV drugs flow like a pharmaceutical river; oxygen and nitrous swirl in a gaseous vapor.

The magic of health care is expensive, though.   In 2011, the United States spent 2.5 trillion dollars on health care.

(I don't think all that went to the nurses.  At least, it didn't go to me.)

And pain--hospitals are full of pain.  Drawing blood, starting IV's, cutting off limbs, sawing open chests, drilling into skulls. 

Lots of pain.

But, the pain and the exorbitant cost are worth it, because this is your life we are talking about.  It's your LIFE.  Right?  

That's what I thought.  But, I see people everyday who come to the hospital and then won't help themselves get better.

They act like I am the enemy.  They call me names.  A few of which are actually true. 

The way that my mother might have made a living has been brought to my attention.  I have been told that my parents were not actually married.  It has been suggested that I am in the wrong taxonomic class.

Nurse's Note:  I don't actually know what my mother did for a living.  She SAID she was an air traffic controller, but she might have been lying!  If she really was a prostitute, she sure dressed badly for that job.  

Another Nurse's Note:  I don't know for sure that my parents were married.  I wasn't invited to the ceremony.

Patients have come in fluid overloaded, struggling to breathe, eyes popping, rhonchi audible from the parking lot,  blister-covered feet like rising purple dough--and then they argue endlessly with you about how they want more water. 

All of my reasonable explanations are met with anger and denial.  I am a hateful bitch.  I don't know what I am talking about. 

I catch them drinking out of the sink.  I turn the water to the sink off.

I catch them drinking out of the toilet.


Sometimes, patients try to turn their health care into a power struggle.  "I'm not taking that pill unless you bring me another ice cream!"

"I'm not gonna be your guinea pig!"

I really want to say, "Great!  Works for me!"  and walk out.  

Instead, I have to say (in as reasonable of a voice as I can muster) "Of course, you don't have to take any medication that you don't want.  You are not a prisoner here.  My job is to educate you and to tell you what we are doing and why.  If you don't want to do it, we won't to make you."

Arguments go something like this:

"You can't make me stay in this bed!" 

But--you have a balloon pump in your femoral artery...

"I'm tired of this blood pressure cuff!  I'm not wearing it!"

But--we are titrating norepinephrine to sustain your blood pressure...

"I want my mother in here RIGHT NOW!!"

But--we are in the middle of a sterile procedure...

"I'm not wearing those leg things!! They make me hot and keep me awake!"

Uhhh...blood clots...stroke...pulmonary embolism...

Don't come to the hospital and then refuse to do what the medical team recommends.  Would you take your car to a mechanic, ask their advice, pay for it, and then refuse to do it?

We are all adults here.  If you are unhappy, leave.  

If you choose to stay, then work with us to improve your health.  We'll all be happier.

Nurse's Note:  Nurses are paid the same regardless of their patient's compliance with medications, blood draws or tests.  After twelve hours, the nurse walks out the door, whistling a jaunty tune, her car keys jingling. 

The sky is a wash of crystal blue. 

(c) copyright 2012 by the author of this blog. All rights reserved.